Potentially valuable physiologic and pathologic data is being lost daily in large trauma centers due to inadequate facilities or programs for careful, systematic prospective studies of injured patients. This program study is designed to develop a long term project to gather a maximal amount of clinical and research data on a large population of acutely injured patients. The studies have been divided into five broad catagories which reflect general problems but allow sufficient flexibility for overlap and for evolution of related subprojects. These categories are: (1) Definition of body fluid and cellular changes in response to shock and resuscitation. These include: a) measurements of cell function and membrane transport induced by shock; b) construction of an in vitro model to evaluate interstitial transport and comparison of the changes seen in this model with in vivo interstitial transport; c) evaluation of the pulmonary and coagulation changes accompanying hemorrhagic shock and resuscitation. (2) Hematologic and circulatory changes in the initial response to injury, including thermal injury. The primary emphasis of this project is on circulating products of extra vascular coagulation which produce systemic injury. (3) Physiologic and biochemical alterations in oxygen transport in the injured patient (including an evaluation of the various mechanisms of ventilatory therapy on oxygen transport). (4) Alterations in renal function and general cellular injury occurring as a result of sepsis, burns and soft tissue trauma. (5) Alterations in pulmonary function in the injured patient and evaluation of treatment modalities. These include: a) patient and animal investigation of the possible etiologic factors involved in pulmonary failure following injury; b) an evaluation of the clinical application of ventilatory therapy and with further investigation into methods for identifying and moderating pulmonary function in injured patients.